title: Endoscopic ultrasound guided fine needle aspiration of malignant pancreatic lesions.
abstract: OBJECTIVE
  To evaluate the accuracy, safety, and clinical utility of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of pancreatic masses.
  
  
  METHODS
  Forty-seven patients were referred for EUS with a pancreatic mass and suspicion of pancreatic cancer based upon painless obstructive jaundice, epigastric abdominal pain plus weight loss/anorexia, or idiopathic pancreatitis. All patients underwent EUS with both radial (Olympus UM20) and linear array (Pentax FG32-UA) systems. After TNM staging by EUS, ultrasound directed FNA of the pancreatic mass was performed using a 23 gauge, 4 cm long needle.
  
  
  RESULTS
  EUS-guided FNA was performed in all 47 patients. Results: successful targeting = 100%, adequate cellularity = 100%,
  
  
  RESULTS
  adeno Ca = 25, squamous cell Ca = 1, lymphoma = 1, poorly differentiated Ca= 1, atypical cytology or suspicious for carcinoma = 9, no malignant cells = 10. The sensitivity, specificity, positive predictive value and negative predictive value of EUS-guided pancreatic FNA for the diagnosis of malignancy was 64%, 100%, 100% and 16% respectively.
  
  
  CONCLUSIONS
  EUS with FNA is useful for detection of malignancy in a pancreatic mass. The procedure appears to have a complication rate of 2%. Impact of this technique on clinical management of patients needs further evaluation.
authors.affiliation: VA Medical Center, Dayton, Ohio, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Bhutani
authors.forename: R H
authors.initials: RH
authors.lastname: Hawes
authors.forename: P L
authors.initials: PL
authors.lastname: Baron
authors.forename: A
authors.initials: A
authors.lastname: Sanders-Cliette
authors.forename: A
authors.initials: A
authors.lastname: van Velse
authors.forename: J F
authors.initials: JF
authors.lastname: Osborne
authors.forename: B J
authors.initials: BJ
authors.lastname: Hoffman
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D009366:Neoplasm Seeding; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional